Theophylline overdose

Treated by hemoperfusloD A IS-year-old girl (43kg) took 7 tablets (1.575&) of sustained release theophylline ('Phyllocontin') in a moment of stress. Gastric lavage 2 hours later recovered only a small amount of tablet debris. She seemed wel1 for 10 hours before sudden hypotension and tachycardia were followed by cardiorespiratory arrest After resuscitation she had profound acidosis, hypokalemia and cardiac arrbythmias. Tbe theophylline level I 6 hours after the dose was 146 mg / L (therapeutic 5-15mg/ U. She started having frequent convulsions. After 3 hours of hemoperfusion with a charcoal column ('DHP- I Hydron Haemoperfusion Cartridge'; Kuraray, Japan) the theophylline level was 3lmg!L An estimated 920mgof theophylline (58 % of the dose) had been cleared from the blood. Analysis 8 hours later showed no rebound in the drug level. Jefferys. O.B. et al : British Medical Journal 280: 1167 (IOMay 1980)

Seizures in neonates: first report A 3262g girl born at 37 weeks' gestation developed cyanosis and tachypnea within hours of birth. This became more severe after 12 hours and persisted despite continuous positive airway pressure therapy. 18mg IV aminophylline was ordered but the child actually received I 80mg. Two hours later the heart rate was 170 beats/ min, the child was irritable, she vomited and generalized seizures occurred . The serum theophylline level 2 hours after the dose was 51 mg/Utherapeutic range 6-11 mg!U The seizures were controlled with phenobarbital 15mg/kg IV and recovery was uneventful. A premature I 028g girl developed severe apnea and bradycardia on the second day of life. The apnea was successfully controlled with aminophylline until day 17 when mechanical ventilation was required. The girl be8an to have seizures so theophylline was stopped and phenobarbital was given. On day 20, apnea recurred so theophylline

was given again bUI after 3 days seizures occurred and it was discovered that the theophylline had been given at 10 times the prescribed dose. Serum theophylline level was 54mg/L Gal. P. et al.: Pediatrics 65, 54HMar 1980)

8 Reactions Jon 27 1980 0157-7271/80/0627-0008/0$00.50/0 IrJ ADISPress